Why thousands of healthy women are secret SNORERS, putting them at risk of heart attacks, strokes and worse. Helen disrupted her entire family – until a brilliantly simple, immediate cure changed her life

Helen Robinson didn’t even know she snored until she was sharing a hotel room with one of her daughters after a family party. She was slim, fit and didn’t drink much – in short, a far cry from the stereotypical snorer.

“I was really ashamed when my daughter told me,” says Helen, 66, a retired special education teacher and divorced mother of three from Bromley, Kent.

‘I live alone, so I just didn’t know. Apparently I’ve been disturbing her on and off all night.

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‘It was humiliating. I thought it was really unladylike, something you associate with overweight men.’

It never occurred to Helen to see a doctor. But in the months after the party in 2023, she experimented with different sleeping positions and bought several “anti-snoring pillows” that would promote lying on the back.

Helen also noticed that she woke up with a headache and a dry mouth.

“I felt unrefreshed and dizzy,” she recalls. ‘I also had a dry cough that I couldn’t clear, but I didn’t have a chest or throat infection.

‘As the year went by, I noticed that I was waking up more and more at night and couldn’t get back to sleep.’

She attributes her symptoms to “being older” – but in fact they are hallmark signs of obstructive sleep apnea (OSA), a chronic sleep disorder in which breathing repeatedly stops and starts because the throat muscles temporarily collapse and block the airway.

The repeated drop in oxygen not only causes snoring (the soft tissue in the nose and throat vibrates as air is forced past it), but also causes a rise in adrenaline that wakes the person up and initiates breathing.

But this causes blood pressure to rise, and over the years these increases can damage the cardiovascular system, increasing the risk of heart attack and stroke.

Helen was fed up with waking up at night and not feeling well and called her GP for advice in January 2024.

Nearly a year later, after several tests, including lung function checks and wearing a pulse oximeter on her finger to measure the oxygen in her blood while she slept, Helen was diagnosed with OSA.

OSA affects an estimated 12 million people in Britain – but 85 percent are undiagnosed.

It is usually thought that snorers, including those with OSA, are mainly older, overweight men – figures show that it is diagnosed around three times more often in men than in women.

But now research shows that OSA is much more common in women than previously thought, and that it increases after menopause.

A study of 1,300 women published last year in the journal BMC Endocrine Disorders found that 36 percent of premenopausal women had OSA symptoms, rising to 53.9 percent of postmenopausal women.

And this will increase. Researchers at the ResMed Science Center in San Diego, California, predicted in December in The Lancet Respiratory Medicine that the number of cases of OSA in women will increase by 65.4 percent by 2050, compared to a 19.3 percent increase in men – partly due to an aging population and greater recognition of the condition in general.

Kat Lederle, a sleep scientist at London General Practice, says cases in women are under-diagnosed, partly because they are more ashamed and think snoring is not ‘feminine’.

“So when they come to the clinic, they’re much more likely to say they’re tired than to admit they’ve snored,” she says.

There are a number of reasons why menopause is a major trigger. Not only is it a time when extra weight creeps in, but Kat Lederle also points to a drop in the hormones progesterone and estrogen.

“These hormones strengthen the muscles in the airways before menopause,” she says. ‘As levels drop, muscles weaken and airways are more likely to collapse.’ This could help explain why slim and healthy women like Helen develop OSA.

A complicating factor in making the correct diagnosis is that the symptoms can differ in women.

A 2024 study found that while many women had the classic symptoms such as headaches, snoring, disturbed sleep and waking up unrefreshed, about a third had very few symptoms, or the symptoms were less pronounced.

Furthermore, as in Helen’s case, these patients did not have the common cardiovascular risk factors such as high blood pressure and obesity associated with OSA, the journal Sleep Medicine reported.

And as Dr David Garley, GP at the Better Sleep Clinic in Bristol, explains, although sleep apnea is ‘common in women at the moment, there is an intersection with menopausal symptoms such as brain fog, irritability and muscle pain. So OSA can often be wrongly attributed to other health problems or go under the radar.’

Helen was offered the NHS gold standard treatment for OSA: continuous positive airway pressure (CPAP), which involves blowing air into your nose while you sleep to prevent airway collapse.

However, a study published last year in the journal Sleep Breath found that fewer than half of patients adhered to CPAP therapy, citing nasal congestion, discomfort and claustrophobia.

Alternatives to CPAP include a custom-made mandibular advancement device, essentially mouthguards worn during sleep that prevent the tongue from falling back and blocking the airway. These are recommended in the NHS guidelines for mild OSA but are not routinely available. Privately they cost around £1,000.

There is also a newer treatment called Inspire therapy, which is a device implanted under the collarbone with a breathing sensor and pacing cable (similar to a pacemaker). It detects breathing and provides mild stimulation to the tongue and muscles needed to keep the airways open. ‘This is available on the NHS, but not everywhere,’ says Dr Garley.

Helen wasn’t keen on the idea of ​​the CPAP as she thought it would disrupt her sleep even more and would be a pain to take with her on holiday.

“I was also worried that my grandchildren would get scared if they stayed overnight, or that I wouldn’t be able to hear them because of the noise of the machine if they woke up.”

A few weeks after her diagnosis, she happened to have a dentist appointment and mentioned that she snored. They suggested she try the custom-made mandibular locomotion device.

A study published in Dentistry Journal in 2023 showed a success rate of 81 percent in patients with moderate OSA and 73 percent in patients with severe OSA using one of these devices.

Custom-made mandibular advancement devices work by moving the mandible forward from the resting position – this brings the tongue forward and increases the airway space behind it, explains Ama Johal, professor of orthodontics at Queen Mary University of London.

Helen started wearing the device in March last year. As usual, she had to make incremental jaw adjustments to move her jaw forward by just 0.5mm every week until she found the sweet spot, which could take a few months, says Professor Johal, clinical lead at Aerox Health, a manufacturer of mandibular advancement devices.

“Usually, patients will recognize this when they wake up feeling refreshed as if they had a good night’s sleep,” he says.

Within weeks of using her device, Helen’s symptoms improved dramatically, eliminating headaches and waking up refreshed.

“I didn’t wake up that often during the night,” she remembers. ‘A snoring app showed that I wasn’t having as many sleep apnea episodes.’

She insisted on another NHS oximeter test, which confirmed her OSA had improved from moderate to severe to mild in just eight months. She continues to use the device.

‘It’s a huge relief to stop snoring and know I’ve reduced my risk of having a heart attack or stroke. My message to women is: don’t ignore snoring or be ashamed of seeking help; you may be overlooking a serious health problem.”